pointed out that it is not a well known fact but death and dying was the subject of the early grounded theory research of the pioneers of this type of enquiry, Bamey Glaser and Anselm Strauss.
Before proceeding further, let me make a comment about the role of the literature review in qualitative research. According to Shank (2002), one school of thought is that
"ignorance is bliss", meaning that it is best to review the literature at the end of data collection so that one has a fresh perspective when collecting data. The other school of thought recognizes the importance of understanding the literature on the topic prior to collecting data. Because I was quite familiar with the literature on AIDS-related bereavement long before I decided to pursue the present research study, I did not have the option of forgetting all that I had read on this subject. But as Shank indicated, reviewing the literature beforehand can demonstrate that our knowledge of a topic is "somehow incomplete" and that "we simply do not understand it well enough" (p. 124). In my case, I realized from my review of the literature that very little was known about AIDS-related bereavement in the South African context, so it was useful in this regard.
gathering process a bit. When things did not always go exactly as planned, this naturally created some anxiety for me, since I had scheduled a block of time to be in South Africa to collect data and I was concerned that I would not be able to get all my interviews done on time. Thankfully, everything worked out well in the end.
I wish to add a comment about recruiting participants through these gatekeepers.
Gaining access to people to talk about sensitive issues around HIV/AIDS is not easy and gatekeepers can be a useful means of recruiting participants. However, the drawback to using gatekeepers in community organizations and other NGOs is that the findings are likely to be skewed toward individuals who are being served by these organizations (Pierret, 2000). The experiences of bereaved individuals who are not connected to services are ignored. This is an important limitation to bear in mind when interpreting the findings of the present study since many participants (though not all) in the sample were receiving some kind of service from a community organization.
Theoretical and purposeful sampling was used in the selection of the bereaved partICIpants. Participants had to be over the age of 18 and report an important relationship to a person/s that had died of AIDS at some point in the recent past.
Participants were given the opportunity to determine who was important in their lives rather than me giving them predetermined categories of relationships. It was not presumed that the relationship to a blood relative was more important than that of a close friend, or partner. The sample was also not limited to participants who had lost a loved one to AIDS within a set time period (e.g., no more than two years after the death). I felt that opening up the sample to participants who experienced AIDS-related deaths from some time ago (e.g., five years ago) as well as participants who had lost loved ones recently, would provide a picture of the nature of bereavement for individuals at different points during the AIDS epidemic in South Africa (chronosystem).
My main selection criterion was that participants had to be adults who had experienced the loss of a loved one to AIDS. Because of the stigma and secrecy surrounding HN/AIDS in South Africa, I was concerned about my ability to recruit participants who would be willing to share their experience. I decided to focus my research on residents in and around Durban, KwaZulu-Natal because I needed access to participants who were nearby. This was important because my interviews would be in
depth and I needed to follow up with participants. I also had to consider the emotionally draining nature of the data collection process and the possible psychological reactions of participants. I felt that these factors took precedence over recruiting large numbers of participants from all over South Africa which I would have done if I was conducting a quantitative study and if I wanted to ensure that my findings would be generalizable.
Rather, my purpose was to gather and analyze qualitative data from a group of bereaved participants in one context and I had no intention of purporting that this information would be representative of all people bereaved by AIDS in South Africa. Shank (2002, p.
94) asserted that it is betterinqualitative research to have samples that are "fertile" than
"typical" ones. He indicated that "generalizability is most often a push toward breadth, and qualitative research is much more concerned with depth" (p. 94).
My sample eventually consisted primarily of Black women who were poor and living in and around the Durban area. Many participants were HIV-infected themselves.
Although it was not a conscious decision on my part, the sample ended up resembling the pattern of those who are predominantly affected by HIV/AIDS in South Africa (Johnson
& Budlender, 2002).
The number of participants was determined as the research progressed. I recruited and interviewed participants until it was determined that no new themes emerged from the analyses, categories were developed in terms of properties and dimensions, and relationships among categories were well established and validated (i.e., a state of theoretical saturation was reached) (Strauss & Corbin, 1998). A total of 18 participants from the primary sample were interviewed for this study. Qualitative studies typically consist of small samples since the aim is to interview participants in depth. Based on the amount and quality of data generated, I felt that the size of the sample in this study was sufficient to provide for contextually rich narratives that would deepen our understanding of the grief response and coping strategies of people bereaved by AIDS in and around Durban, KwaZulu-Natal.
Purposive sampling was used in the recruitment of key informants. This secondary sample consisted of eight human service professionals (including social workers, a psychologist and a nurse) who were directly involved in providing services to people from all areas of KwaZulu-Natal who were infected and affected by HIV/AIDS. They
worked in various settings including a hospital-based HIV/AIDS support program, a large child welfare NGO whose mission included providing services to children infected and affected by HIV/AIDS, two church-based NGO's serving people with HN/AIDS in outlying rural areas, an in-patient palliative care program for AIDS patients, and a NGO that specialized in providing support groups and counseling for people affected by HIV/AIDS.